Recent incidents in Canada – such as the Andrew Potter/McGill University affair – have highlighted the contentious balance between expressing political views and maintaining academic freedom. Beyond the question of the appropriateness of what an individual says, however, lurks the broader question of what place politics has within academic disciplines.

In the field of medicine, two very different views on the proper role of politics have been on display in Ottawa in recent weeks. The first appeared in a memo sent from Jacques Bradwejn, Dean of Medicine at the University of Ottawa, to his faculty members. It stated that “the field of medicine isn’t without its controversial issues (i.e. safe injection sites, safe abortions and physician assisted dying), but politically charged messages along with any other material unrelated to the practice of medicine are a distraction from the teaching of the subject at hand.”

The other view, making the case for the inseparability of politics from medicine, was reiterated just down the street from UOttawa. In February, federal Health Minister Jane Philpott approvingly tweeted this famous adage of 19th-century Prussian physician Rudolf Virchow:

“Medicine is a social science, and politics is nothing else but medicine on a large scale. Medicine, as a social science, as the science of human beings, has the obligation to point out problems and to attempt their theoretical solution; the politician, the practical anthropologist, must find the means for their actual solution.”

This was accompanied by a more personal message from the minister reflecting upon the continued significance of Virchow’s words: “Bill C37 passed 3rd reading. To save lives through harm reduction. Reminded me why I went into politics, to find means for actual solutions.”

The bill in question makes it easier to open and operate safe drug consumption sites in Canada. Reforming the law in order to permit facilities the use of otherwise illegal drugs is a textbook example of the intersection of politics and medicine.

In turn, textbook examples belong in the classroom. Politically, safe consumption sites have always been controversial. The tipping point in changing the law has been the vast body of evidence illustrating that these sites offer clear public health benefits. It is impossible to teach this evidence without reference not just to the simple existence of political controversy, but to the fact that differing political stances have decidedly different real-world implications for health.

Particularly in the era of so-called “alternative facts,” it is crucial that laws governing our health be evidence-based. It is similarly crucial that those who are learning how to act in the best interests of their patients be taught that there will be times when the most effective cure for what ails those patients may be political rather than surgical or pharmaceutical. In such cases, politically charged messages are fundamentally relevant to the practice of medicine.

Thus, while political discussion should be held to reasonable standards of professional decorum, well-founded criticisms of policies, and their proponents, have every place in the classroom. Virchow himself is not immune from critique. For instance, he maintained his belief, in the face of the evidence to the contrary, that microscopic bacteria were not the cause of diseases such as cholera. Given his medical and political influence, his intransigence served to delay the creation and implementation of public health policies necessary to save lives.

Virchow also serves as a reminder of the risks that come with overstepping the bounds of propriety when voicing opinions. In one instance, the incensed Prussian Chancellor Otto von Bismarck challenged Virchow to a duel. Here (or so the story goes), only Virchow’s medical expertise – particularly his groundbreaking work in parasitology that made him an early proponent of meat inspection – got him out of trouble. Asserting his right as the one being challenged to choose the weapons and format of the duel, he picked a parasite-infested sausage that his opponent ultimately declined to consume.

Allegorical or not, it was a fitting choice given that Bismarck is himself the figure most popularly associated with the maxim that the process of making laws, like the making of sausages, is not a pretty one. By contrast, Virchow would have recognized that ensuring both laws and sausages are properly made is vital to the health of society. Politics and medicine belong in the grinder together, even if the process is not always for the squeamish.

Adam R. Houston is a PhD Candidate in the Faculty of Law at the University of Ottawa working at the intersection of law and health. Twitter: @HealthLawAdamH

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